Risk factors for SARS-CoV-2 infection among healthcare workers in Rajasthan: A Case-Control Study aligned with WHO UNITY protocol

Pankaj BhardwajCommunity Medicine, and Family Medicine, Coordinator School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Leyanna Susan GeorgeDepartment of Community Medicine, Amrita Institute of Medical Sciences, Cochin, India

Manoj Kumar GuptaCommunity Medicine, and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Akhil Dhanesh GoelCommunity Medicine, and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Nitin Kumar JoshiSchool of Public Health, AIIMS, Jodhpur, India

Neha MantriSchool of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Nitesh KumarDepartment of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Jinesh SainiSchool of Public Health, AIIMS, Jodhpur, India

Vidhi JainDepartment of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Suman SaurabhCommunity Medicine, and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Chitra TomyDepartment of Community Medicine, Amrita Institute of Medical Sciences, Cochin, India

Gopal Krishna BohraDepartment of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Nishant Kumar ChauhanDepartment of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Manoj VermaDepartment of Community Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India

Arun KumarDepartment of Community Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India

Suman BhansaliDepartment of Community Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India

Niti GahlotDepartment of Community Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, Jodhpur, India

Archana PaliwalDepartment of Community Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, Jodhpur, India

Rajaat VohraDepartment of Community Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, Jodhpur, India

Vijaya Lakhsmi NagDepartment of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

M. K. GargDepartment of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Sanjeev MisraDepartment of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

DOI:

https://doi.org/10.3396/ijic.v21.23283

Keywords:

COVID-19, IPC, Hand Hygiene, Patient care, Risk factors, Health personnel, Hospital, India

Abstract

Background: Understanding the risk factors for healthcare workers (HCWs) involved in COVID-19 care is essential for developing effective infection prevention strategies.

Methodology: A case-control study, aligned with the World Health Organization UNITY protocol and using the WHO Go.Data template, was conducted in Rajasthan across three public hospitals to identify factors associated with COVID-19 infection among HCWs. Data were analyzed using SPSS v.23. Descriptive analysis included COVID-19 positivity rates, exposure frequency and duration, and Infection Prevention and Control (IPC) practice scores. Chi-square and Fisher’s exact tests (P < 0.05) were used to assess associations.

Results: A total of 196 participants (50 cases and 146 controls) were enrolled. Among the cases, 54% were doctors and 42% were specifically assigned to COVID-19 care, with an average exposure duration of 8.8 ± 4.9 days over the prior 2 weeks. Notably, 36% experienced long-term face-to-face exposure. Of all variables, only hand hygiene before and after patient material contact showed a significant association with infection (P = 0.036).

Conclusion: These findings underscore the need for strengthened IPC adherence, particularly hand hygiene, among HCWs in high-exposure settings.

How to Cite:

Bhardwaj, P., George, L. S., Gupta, M. K., Goel, A. D., Joshi, N. K., Mantri, N., … Misra, S. (2025). Risk factors for SARS-CoV-2 infection among healthcare workers in Rajasthan: A Case-Control Study aligned with WHO UNITY protocol. International Journal of Infection Control, 21. https://doi.org/10.3396/ijic.v21.23283

References

1. Nguyen LH, Drew DA, Joshi AD, Guo CG, Ma W, Mehta RS, et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. medRxiv Prepr Serv Heal Sci. 2020. doi: 10.1101/2020.04.29.20084111

2. The Lancet. COVID-19: protecting health-care workers. Lancet 2020; 395(10228): 922. doi: 10.1016/S0140-6736(20)30644-9

3. Misra-Hebert AD, Jehi L, Ji X, Nowacki AS, Gordon S, Terpeluk P, et al. Impact of the COVID-19 pandemic on healthcare workers’ risk of infection and outcomes in a large, integrated health system. J Gen Intern Med. 2020;35(11):3293–301. doi: 10.1007/s11606-020-06171-9

4. Klompas M, Morris, Shenoy E. Universal masking in hospitals in the COVID-19 era. Salud(i)Ciencia 2020; 24(2): 41–3. doi: 10.1056/NEJMp2006372

5. Ferreira FB, Costa GB, Sevá A da P, Albuquerque GR, Mariano APM, Lopes ATS, et al. Characteristics and factors associated with sars-cov-2 infections in individuals that attended referral hospitals from southern region of bahia state, Brazil: a surveillance network retrospective study. Viruses 2021; 13(12): 2462. doi: 10.3390/v13122462

6. Iavicoli S, Boccunii F, Buresti G, Gagliardiid D, Persechino B, Valenti A, et al. Risk assessment at work and prevention strategies on COVID-19 in Italy. PLoS One 2021; 16: 1–11. doi: 10.1371/journal.pone.0248874

7. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012; 7(4): e35797. doi: 10.1371/journal.pone.0035797

8. Cirrincione L, Plescia F, Ledda C, Rapisarda V, Martorana D, Moldovan RE, et al. COVID-19 pandemic: prevention and protection measures to be adopted at the workplace. Sustain 2020; 12(9): 1–18. doi: 10.3390/su12093603

9. Atnafie SA, Anteneh DA, Yimenu DK, Kifle ZD. Assessment of exposure risks to COVID-19 among frontline health care workers in Amhara Region, Ethiopia: a cross-sectional survey. PLoS One 2021; 16: 1–14. doi: 10.1371/journal.pone.0251000

10. Liu M, Cheng SZ, Xu KW, Yang Y, Zhu QT, Zhang H, et al. Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study. BMJ 2020; 369: 6–11. doi: 10.1136/bmj.m2195

Copyright (c) 2025 Pankaj Bhardwaj, Leyanna Susan George, Manoj Kumar Gupta, Akhil Dhanesh Goel, Nitin Kumar Joshi, Neha Mantri, Nitesh Kumar, Jinesh Saini, Vidhi Jain, Suman Saurabh, Chitra Tomy, Gopal Krishna Bohra, Nishant Kumar Chauhan, Manoj Verma, Arun Kumar, Suman Bhansali, Niti Gahlot, Archana Paliwal, Rajaat Vohra, Vijaya Lakhsmi Nag, M. K. Garg, Sanjeev Misra

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors retain copyright of their work, with first publication rights granted to IJIC. Read the full Copyright- and Licensing Statement.